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Free Content Evaluation of sputum smear microscopy in the National Tuberculosis Control Programme in the north of Vietnam

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Abstract:

OBJECTIVE: To assess the yield of sputum smear microscopy and sex differences in the National Tuberculosis Control Programme in the north of Vietnam.

METHODS: Review of registers of 30 randomly selected laboratories (26 district, 4 provincial level).

RESULTS: The average daily workload per technician was 4.4 examinations in district and 5.3 examinations in provincial laboratories. To find one smear-positive case, 9.7 suspects were examined and 29.3 smears done. The smear-positive rate (mean 10.3%) was higher among men (11.6%) than among women (8.4%, P < 0.001). There were more men than women among tuberculosis (TB) suspects (male:female ratio 1.36, 95%CI 1.19–1.54), but even more so among smear-positive patients (1.89, 95%CI 1.64–2.14), irrespective of specimen quality and number of smears examined. Three smears were examined for 18055 suspects (61.7%). The incremental gain was 33.5% and 4.9% for the second and third smear examination, respectively; 186 (95%CI 160–221) smears needed to be examined to find one additional case of TB with a third serial examination.

CONCLUSION: The diagnostic process seemed generally efficient. The male:female ratios suggest higher TB incidence in men rather than lower access to TB facilities for women. The third smear examination could be omitted.

Keywords: Vietnam; laboratory; microscopy; sex; smear examination; tuberculosis

Document Type: Regular Paper

Affiliations: 1: National Hospital of Tuberculosis and Respiratory Diseases, Hanoi, Vietnam; and Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands 2: National Hospital of Tuberculosis and Respiratory Diseases, Hanoi, Vietnam 3: KNCV Tuberculosis Foundation, The Hague, The Netherlands 4: Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands; and KNCV Tuberculosis Foundation, The Hague, The Netherlands

Publication date: March 1, 2006

More about this publication?
  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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